There are many areas where patient collections can break down, but the most effective place to start improving them is before the beginning. The simple, helpful steps start before we even get a call from the patient and gather their insurance information.
You’re going to want to have copies of the current coverage policies for the insurance companies you bill. These will tell you what limitations there are on coverage for particular services and which diagnosis will be covered when used in conjunction with certain CPT codes. Having this ahead of time can help to avoid those “not medically necessary” denials down the road, and may help you and your patient understand which procedures can help to treat their diagnosis and will be covered under their insurance plan.
The most vital step in improving your patient collections lies in improving your patient benefit verifications. In some offices, insurance verification isn’t done at all. Without it, it’s possible that none of the treatment you give your patient and bill out will be covered by that patient’s policy. This wastes your office resources and also potentially creates an upset patient who believed the services they received would be covered. So it can be very important to your practice to make sure verification is done before the patient is seen, and that it is done well.
Most practices do have some form of verification in place. But if you are finding that what is coming back
from the insurance companies is often not what was expected, it’s time to look into how to improve your insurance verification process. It’s very common that those doing the verification don’t completely understand the process or the questions they are asking. It can be complex, so it’s not surprising. There is almost always room for improvement.
In my next email, I’ll go over the specifics of what makes up good verification and how you can get it done right in your office.
Have a great week!
Kat Jordan
Kat Jordan is the Owner of Orion Billing Services, a professional external billing company. With extensive experience in healthcare billing, Orion is well prepared to help with thorough, knowledgeable claims submission, follow-up and collection.
Call (415) 851-1605 for more information.
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